Healthcare Provider Details

I. General information

NPI: 1275799587
Provider Name (Legal Business Name): AMY H. HUANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 DE SOTO AVE
WOODLAND HILLS CA
91367-6701
US

IV. Provider business mailing address

5601 DE SOTO AVE
WOODLAND HILLS CA
91367-6701
US

V. Phone/Fax

Practice location:
  • Phone: 818-719-4330
  • Fax:
Mailing address:
  • Phone: 818-719-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: